Trimetazidine Limits the Effects of Myocardial Ischaemia During Percutaneous Coronary Angioplasty

Summary

This open-label, randomised, controlled study is aimed at assessing the effect of pre-treatment with the metabolic agent trimetazidine on the degree of ischaemia during percutaneous transluminal coronary angioplasty (PTCA).

Overall 44 patients with one-vessel coronary artery stenosis (>70%) in the medial part of the left anterior descending artery were included. One group (n?=?22) was pre-treated with oral trimetazidine. The other group (n?=?22) was the control. All patients (n?=?44) were administered aspirin and conventional treatment.

All patients underwent PTCA; stents were implanted in 11 trimetazidine patients and in seven control patients.

The mean ST-segment elevation during all balloon inflations was significantly lower in the trimetazidine group than in the control group (?1.66?±?1.50?mm vs. 3.29?±?1.59?mm, p?=?0.001). Maximal ST-segment elevations and

mean ST elevation values during sequential balloon inflations were also significantly lower with trimetazidine (p?=?0.018). The mean amplitude of the T-wave alterations during all balloon inflations was significantly lower with trimetazidine (3.09?±?2.39?mm vs. 6.83?±?4.31?mm; p?=?0.001). Similarly, the maximal amplitude of the T-wave alterations was 4.50?±?2.90?mm with trimetazidine vs. 9.25?±?4.97?mm in control patients (p?=?0.0005). Angina and rhythm disturbances were more frequent in the control group. Time from balloon inflation to onset of angina was 50?±?26.2s with trimetazidine vs. 32?±?15.0s, for control group (p?=?0.03). The time to pain relief after deflation was 19.3?±?11.4s with trimetazidine vs. 28.2?±?16.8s (p?=?0.001).

Trimetazidine administered a few days before PTCA appears to be a cardioprotective agent for the prevention of myocardial ischaemia.